comments and staff got back to us and we went back and forth and they acknowledged our issues and in the revised version. i want to thank everyone for this impressive document. thank you. >> thank you. any other speakers? public comment closed we'll open up for commissioners questions and comments. commissioner antonini? >> i have some questions in general about this document. there is a different between city owned medical facilities and non-city owned medical facilities. i guess my concern is that we talk about this eligible for development initiative and some things that would have to be met by institutions that qualify in terms of square footage new

buildings or additions. but, my concern is this where would this go? an example was brought up to changing a medical facility to pool hall. i'm concerned about a medical facility who wanted to locate on the siting by the corridor on the street where you are told you can't do that because there are too many medical institutions. many of our hospitals do not just deal with san francisco residents. many people come from outside the city for services at ucsf and kaiser and even as a dentist i have 30 percent of my patients who reside outside of san francisco. the needs of a

particular medical facility are dictated by their patient base, not necessarily everybody who happens to be living in san francisco. so i have some concerns about what would happen in land use terms because i don't want to put another barrier for development for health care facilities might be beneficial to the city or to many people who are needing health care services. and in particular there was some talk about the obviously having a cultural diverse facility, but how specific would it be? would you be telling institutions that they have to have bilingual staff. i want to know how much teeth is in it. >> thank you for your comments commissioner antonini. the way

ween -- envision is for three possible outcomes. the first is incentives, culturally competent care and serving vulnerable patience. it doesn't mean it's not consistent. if it locates in a place that has sufficient services that is not intended to serve a high needs population, it wouldn't ju be eligible for this model. it's skill consistent. projects that harm health or health care access in san francisco are those that would be deemed inconsistent. consistent applications move forward in the normal incentive in the mormal planning process. it's the ones recommended for

incentives is what gets reviewed and taylored to the ways that each project meets it's incentive eligible activities. >> you brought up that one example but i'm trying to think of some sort of medical facility that is expanding or being established that would not be consistent at all and still a medical facility. the example of changing it to a pool hall is a little extreme. i can understand that we would probably not want to see this change of use being passed, but i'm more concerned about what kind of controls and i assume the controls would be the planning commission, but then there is board of supervisors who would make the decisions. >> that's correct. >> that's my main concern in regards to this because i'm also trying to ask liberty --

a little bit about this incentivizing project. we have asked a lot from san francisco and i don't want to see this used an n a wedge to fast some project because it has higher qualities as you put into this plan. i think you have to look at a project for a lot of different reasons and because i talked about the patient body that these institutions have that may not be san francisco residents. we want them here. they bring jobs, they bring revenues. there is good reason for them to being here and they deserve some treatment over the plan. i'm not sure i like the prioritization of putting fast track projects that you are

recommending here. >> i would also point out this determinations include the word on balance. if the project is on balance addressed one of these recommendations, it looks at the project as a whole. not just exclusive on those particular elements. >> thank you for your answers. >> commissioner wu? >> i also wanted to ask about this concept of on balance. there is 13 i think guidelines that allow for the expedited review. the notion on balance, there was the conversation asked, obviously meeting one guideline doesn't mean on balance. is it a numerical calculation or some sort of judgment put in there as well? >> i think it's a little bit more subjective on that. it depends on the objectives that one or more of those projects would meet. which of the

elements are key at the time. one of the commentors commented on maybe the needs of where those identify now. this could changeover time. we put the burden of proof for any project asking for an incentive to show us why they would be qualified for an incentive. so to a document why that particular neighborhood is identified as a particularly low income or high vulnerable neighborhood and the extent to which to address that issue within that neighborhood as an example. >> thank you. and to be clear incentives are process related incentives and not density bonus, correct? >> so far we've only identified our priority processing because it's something the department already uses. we have been talking to the industry to see if there are others that would be also very useful. but we

were trying to look at things that already have a precedent. we talked to them for example if referrals help. so folks like causer and hospitals, they don't make much of a difference to us but they help the smaller project. i think what we want to do is have the plan and adopt explore and if there is something we can add to this menu. if maybe if it's something more physical, if this is a clinic that wants to a primary care clinic that wants to locate in the bay view and they say we absolutely need more parking in that park of the city that we consider that. but i think we want to have more internal conversation about if it would be easy to implement and how do we track it over time. certainly we wouldn't do it for programmatic if they are meeting the cultural competency incentive,

it would be hard to give a physical incentive if it's something that is a program, something that would be hard for us to track over time. i think we'll start with a priority processing because it's something that we already have and already do for certain projects and it will take a little bit more time to see if we can come up with other creative incentives that would be meaningful to the things that we do want to make sure happen in the city. >> okay, thanks. to confirm then what's in front of us today is to provide a recommendation on this plan with the priority processing. if either fee deferral or some other kind of incentive was to be used, it would have to be in the next version? would it come to us project by project? >> yeah, the plan left it open so that we have incentives. we

think that those details about exactly what it is can be flushed out and doesn't represent an amendment to the plan because priority processing for example is just a policy of the department. it's not something that needs to be adopted by the commission. we can certainly come back to you once we come up with a couple alternatives we can come back to you with those decisions. >> i would appreciate that. >> it depends on the what the incentive is. if it's a fee deferral, it would require legislation, for example. but there are some things that we can do that would not require legislation. it could be commission policy or department policy. it depends on how to incentives get flushed out over time. >> we intend on doing this immediately when we wrap up on the policy that we'll continue to have these conversations so

we have a full menu when this plan is implemented that we have a full men u. >> thank you. >> commissioner borden? >> i want to thank everyone involved and i think it's an oppressive document. i have one comment on the social living and healthy environment and reminded about the loss of the fresh and easy in bay view hunters point. we didn't see a mention around food. that in terms of the healthy environment issue, i think that is part of it and maybe we can incorporate that with promote health with the advanced health promotion and a gym to include in that effect. i also think in

general we don't spend enough time thinking about the healthy food and i want to make sure we incorporate that in the document. >> thank you. >> commissioner chou? >> thank you, i want to thank colleen and the staff that were taking the comments presented by the staff and the commissioners and what is a document that was started as a draft. what i wanted to ask in part because it's not related to health, but more to the planning department are, are the little green blocks that do talk about this incentive and because we are talking about this as a living document, what are the process beyond every 3-year review that say certain things now turn green and others don't because of circumstances that have changed. what is that process beyond as it says a revision of

some sort occurring ever 3 years. as i said even as we move into the care act, there could be significant changes that might in fact call for the ability to look at that circumstance right away. >> so i think that speaks to the value of the document of the twofold value of the document 1 is specifically as it relates to development decisions. that document is approved by the board of supervisors for those particular uses. so, i think that it may require going back to the board of supervisors to change how you treat development projects that are compared for consistency under the plan. but i think your comments gets to the broader issue of the document as a guide for policy decisions over all. i think we do have the ability to update the document more frequently and in response

to health care reform and it's use as a policy document. there is no reason why we couldn't get it updated at the board if it really was a significant land use decision. but i think that that particular piece would require the approval of the board. >> thank you. >> commissioner moore? >> i want to thank everybody particularly supervisor campos to lend his name to bring this forward. while we were working for many months and years and the cry for this document to be in place was loud and clear. this document should be a living document, a living policy element which helps us think differently and comprehensiveively what health care means and the current facts it currently addresses. that doesn't mean feedback to a few comments but needs to

incorporate literally every health care step we take on the levels of the practitioner. every change will have to be reflected because on a larger scale it will influence how we look at preferential treatment incentives. that holds for the planning department as well because now thinking about this as a comprehensive new element in planning, every neighborhood plan, every plan amendment, everything we do including the city, has a master plan. i'm glad it's here. will it need changes, more likely. let's use this as a test drive and see what else it needs. it's like drive the america's cup boat on the bay and need to adjust literally every step of the

way. i see this thing as it's similar to it needs fine tuning, it needs real skilled observation and implementation to make it succeed. thank you. >> commissioner antonini? >> yeah, some questions on some of the findings that is right interest statements, but i'm not quite sure how they tie into whole document. there was mention that there are 117 thousand elderly san franciscans uninsured. the obama administration, i'm not sure how he is the going to be covered. >> certainly more of those people will have insurance after january 1, 2013. we estimate that about two-thirds of the people who are currently uninsured will be eligible for

some kind of health insurance. not everyone will be mandated and not everyone will need health care services. about 1/3 will be uninsured. >> finally we find that families are living san francisco. more families moving out than moving in. i expect that lack of access to health care may be for that. >> not necessarily. if there were fewer families with children perhaps that reflects the need for less of a need for pediatric care as an example or maybe not, i don't know. it's demographic information that's helpful for the task force that

they make. >> could you look at it either way if they had pediatric care or thought of being better pediatric care that may help to reverse this type of thing. okay. those are my main questions on this particular document. there is a lot of different things. i think that should be discussed for a while. there is a lot of detail. but my main concern as i mentioned earlier is that this isn't used as another way to block some beneficial project and/or make it more difficult because our process makes things very expensive in san francisco and one more barrier we don't need. thank you. >> commissioner borden? >> with that i'm going to recommend that we adopt for approval with the board of supervisors and also adopt the

ceqa findings. >> second. >> commissioner singer? >> actually i was considering making a motion. the motion was made. so therefore i -- >> commissioners, each commissioner will take it separately. so you will need to make a motion for the health commission. >> health commission approved. >> commissioner singer? >> you want to second? >> i had a clarifying question, but first congratulations to everyone on this project. it's kind of nice to be a new commissioner and people congratulate you for work you didn't do. in ordinance 300-10, it sas that any change of use to a medical use. that's a capitalized definition in the planning code. in your

executive summary it says any change of use from non-medical use. i just want to understand, because depending on how you reads those they are slightly different. >> there are two, i know claudia can speak to this if i get it wrong. there are two thresholds, one is to change from a non-medical use to a medical use that is 10,000 square foot or more. the example of a pool hall. if you have an existing medical use and it's expanding by 5,000 square feet, then that is also subject to consistent determination. if a clinic wants to add 5,000 square feet. those are subject to conditions. on a medical non-medical that is expanding.

>> from a medical use. >> the basis is what medical use is not subject to the plan. you have a medical use and want to bring in a medical use which is consistent with the plan. medical use would be subject. >> my question is that what was intended in 300-10? >> yes. the medical use is what's subject to. >> if i may, part of the confusion maybe the question is whether if somebody is eliminating the medical use, the opposite question. if someone is adding a medical use that didn't exist before. >> yes, because only medical use is subject to "the master" plan. is that clear?

>> hilary from supervisor campos office is nodding in the background. it's intended to apply from something else to a medical use. >> okay. who is going to make the motion? >> are we ready for a motion from the health commission de? are we going to take each one separately? >> there are two separate questions called. >> i will make the motion that we adopt the resolution following that i will want to put an amendment. >> second. >> my amendment to the motion that was before the table is to change the word rely to utilize under the third resolve as i feel that rather than simply relying this as a living document and one that we should be using and not relying upon and that speaks to more on our page 181 in the document really

describes how the health commission is tending to utilize this particular document to be able to not merely create the stronger length but use this as a road map for broader health policy decision making. i think colleen and staff have written this extremely we may we'll and using the word "utilize" gives us an access role. >> i would accept the amendment. >> accept. second. >> commissioner hill is. >> so you are moving from a medical to non-medical, does that fall under this? >> i thought that was the question. so your example of converting something to a pool hall doesn't apply in this case? >> doesn't apply.

>> i just want to clarify this. >> also development incentives maybe a loaded phrase. i won't do that here. but things like variance on a specific project, would that fall under incentives because it does say the type of incentives that will benefit the particular project. are we envisioning a project that meets a variance for example that geary street office. it may not be one that qualifies for incentives. that would fall under incentives in this that we look more favorably upon because it's consistent with this plan. >> i think we would have to look at that as a possibility. i don't know in terms of variance would require a code change. i think probably focusing on incentives that we

can operate procedurally, but if it requires legislation, it's something we would consider. >> now it's strictly process? >> that's right. >> commissioner moore? >> i would like to ask the maker of the motion to support the resolution proposed by dr. chung for the health commission. that's commendable. >> i will be happy to do it. >> commissioner antonini? >> i just want to know if we have to adopt the ceqa separately. >> it's part of the same motion. >> commissioner sugaya are you accepting the modification? >> yes. >> i believe they are calling the question. >> on the matter to adopt a recommendation for approval as amended, commissioner antonini,

borden, hill it's, wu, sugaya,. that passes. >> commissioner, commissioner sanchez, singer, mcgee, chung, cars mere. >> i want to thank everyone for this project. i think this is a model of how two departments and two commissions can work together to really know what the right hand and the left-hand are doing. i wish more of this would happen throughout the city so we can

have a unified front as a city and work in collaboration with our communities because this has been a private public partnership. barbara? >> i want to thank the staff particularly our deputy director in planning, she's done a fabulous job from the planning department and i would like to thank also both commissions. i would want to say that maybe we should have them meet more often. but i think it was really important to this i about that we do have health care needs in this community and in particularly the bay view hunters point area and we want to attract providers to that area and i hope this master plan will help provide incentives to bring services to those areas. again, i want to thank both commissions. i have had a lot of ability to interact with the planning commission and i

really admire the work that they do and thank you, health commission for supporting this effort. >> commissioners, if there is nothing further, we can move on to the final item on your calendar which is public comment. i have no speaker cards. >> is there any public comment for this hearing? >> seeing none.

>> good afternoon. welcome to the san francisco board of supervisors land use and economic committee i'm scott wiener